Obstructive sleep apnea: one more target in cardiac rehabilitation

Obstructive sleep apnea (OSA) is a highly prevalent sleep-related breathing disorder, often unrecognized and undiagnosed, in patients with established cardiovascular diseases. Considerable evidence is now available in support of a significant association between OSA and increased risk for cardiovascular disease morbidity. OSA has also been recognised as a potential public health issue associated with societal consequences including accidents and work economics. Treatment of OSA would reduce cardiovascular risk and the overall usage of health care resources. OSA might be a modifiable risk factor and screening for OSA should be implemented in cardiac rehabilitation settings.

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Obstructive sleep apnea: personal, societal, public health, and legal implications

Reviews on Environmental Health ◽

10.1515/reveh-2018-0068 ◽

2019 ◽

Vol 34 (2) ◽

pp. 153-169 ◽

Cited By ~ 13

Author(s):

Nesreen E. Morsy ◽

Nesrine S. Farrag ◽

Nevin F.W. Zaki ◽

Ahmad Y. Badawy ◽

Sayed A. Abdelhafez ◽

...

Keyword(s):

Public Health ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Motor Vehicle ◽

Work Productivity ◽

Legal Aspects ◽

Occupational Accidents ◽

Organ Systems ◽

Obstructive Sleep ◽

Increased Risk

Abstract Introduction Obstructive sleep apnea (OSA) is a widely prevalent sleep-related breathing disorder, which leads to several life-threatening diseases. OSA has systemic effects on various organ systems. Untreated OSA is associated with long-term health consequences including hypertension, heart disease, diabetes, depression, metabolic disorders, and stroke. In addition, untreated OSA is reported to be associated with cognitive dysfunction, impaired productivity at the workplace and in an increased risk of motor vehicle accidents (MVAs) resulting in injury and fatality. Other consequences of OSA include, but are not limited to, impaired vigilance, daytime somnolence, performance deficits, morning headaches, mood disturbances, neurobehavioral impairments, and general malaise. Additionally, OSA has become an economic burden on most health systems all over the world. Many driving license regulations have been developed to reduce MVAs among OSA patients. Methods Studies of the personal, societal, public health, and legal aspects of OSA are reviewed. Data were collected through the following databases: MEDLINE, Google Scholar, Scopus, SAGE Research Methods, and ScienceDirect. Conclusion OSA leads to worsening of patients’ personal relationships, decreasing work productivity, and increasing occupational accidents as well as MVAs. The costs of undiagnosed and untreated OSA to healthcare organizations are excessive. Thus, proper management of OSA will benefit not only the patient but will also provide widespread benefits to the society as a whole.

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Comparisons Of Demographical And Sleep Architecture Between OSA Patients With Various Severities And Developing A Simple Prediction Model

Pulmonary Medicine & Respiratory Research ◽

10.24966/pmrr-0177/100052 ◽

2020 ◽

Vol 6 (4) ◽

pp. 1-10

Author(s):

Wen-Te Liu ◽

Keyword(s):

Public Health ◽

Risk Factors ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Simple Model ◽

Dietary Habits ◽

Public Health Issue ◽

Demographic Structure ◽

Important Public Health ◽

Obstructive Sleep

Due to changes in dietary habits and demographic structure, obstructive sleep apnea with obesity and aging as risk factors has become an important public health issue. The aim of this study is to investigate the relationships between demographics features as well as sleep characteristics of patients and severity of OSA and using easily available measurements to develop a simple model for rapidly identify OSA patients.

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Obstructive sleep apnea and chronic kidney disease: open questions on a potential public health problem

Journal of Thoracic Disease ◽

10.21037/jtd.2017.12.12 ◽

2018 ◽

Vol 10 (1) ◽

pp. 45-48 ◽

Cited By ~ 3

Author(s):

Oreste Marrone ◽

Maria R. Bonsignore

Keyword(s):

Public Health ◽

Chronic Kidney Disease ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Kidney Disease ◽

Health Problem ◽

Public Health Problem ◽

Open Questions ◽

Obstructive Sleep ◽

Potential Public Health

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Rationale and design of remotely-supervised cardiac rehabilitation study in patients with obstructive sleep apnea

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.207 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

J Hnatiak ◽

O Ludka ◽

L Batalik ◽

P Winnige ◽

F Dosbaba

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cardiac Rehabilitation ◽

Public Institution ◽

Moderate Intensity ◽

Newly Diagnosed ◽

Cpap Therapy ◽

Phone Calls ◽

Obstructive Sleep ◽

Home Conditions

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Ministry of Health Czech Republic; identification of organization 65269705 Background Although continuous positive airway pressure (CPAP) is currently still the gold standard for therapy of moderate to severe obstructive sleep apnea (OSA), another alternative or adjunct effective therapeutic options exist. Lifestyle intervention focused on nutrition and weight reduction, regular exercise, sleep hygiene, smoking and alcohol restriction represents a recommended therapeutic strategy for OSA. Though this intervention represents an effective tool for improving objective and subjective parameters of OSA, it’s effectivity depends on components of the intervention, OSA severity and gender. Comprehensive remotely-supervised cardiac rehabilitation (CR) represents possible training intervention in home conditions using elements of telemedicine. Purpose This prospective study aims to investigate the feasibility and effect of a remotely-supervised CR in patients with newly diagnosed OSA with Apnea-Hypopnea Index greater than 15 episodes per hour. Methods This monocentric study is designed as a prospective, parallel, randomised, controlled trial of remotely-supervised 12-week CR in male patients between 40-60 years old with newly diagnosed OSA indicated to CPAP therapy. The sample size is calculated by 0,05 level of significance and 80% statistical power on 25 participants in each group. The Intervention group will undergo comprehensive remotely-supervised CR in home conditions with teleconsultation (contains telecoaching, telemonitoring) via regular phone calls and e-mails at least 1-2 times a week. The intervention will include nutrition, health-related lifestyle and behavioral changes recommendations, and at least 5 times a week 30 minutes of moderate-intensity aerobic training, 10 minutes of inspiratory and expiratory muscle training with breathing device and 10 minutes of oropharyngeal exercise along with individually titrated CPAP therapy. The control group will undergo individually titrated CPAP therapy only. The participants in both groups will go through the following assessments before and after this study: polysomnography, spirometry, anthropometry and body composition examination, laboratory values examination, quality of life questionnaires, Epworth sleepiness scale, 6-min walking test. Conclusions: Comprehensive remotely-supervised CR, as mentioned in this study, may represent an adjunct therapy with a promising future in patients with OSA. The study is occupied with a current issue and can also bring new possibilities and experiences in remote rehabilitation.

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827 Central Sleep Apnea in a patient with Multiple Sclerosis

SLEEP ◽

10.1093/sleep/zsab072.824 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A322-A323

Author(s):

Rahul Dasgupta ◽

Sonja Schütz ◽

Tiffany Braley

Keyword(s):

Multiple Sclerosis ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Disordered Breathing ◽

Central Sleep Apnea ◽

Progressive Multiple Sclerosis ◽

Obstructive Sleep ◽

Increased Risk ◽

Demyelinating Lesions ◽

The Brain

Abstract Introduction Sleep-disordered breathing is common in persons with multiple sclerosis (PwMS), and may contribute to debilitating fatigue and other chronic MS symptoms. The majority of research to date on SDB in MS has focused on the prevalence and consequences of obstructive sleep apnea; however, PwMS may also be at increased risk for central sleep apnea (CSA), and the utility of methods to assess CSA in PwMS warrant further exploration. We present a patient with secondary progressive multiple sclerosis who was found to have severe central sleep apnea on WatchPAT testing. Report of case(s) A 61 year-old female with a past medical history of secondary progressive multiple sclerosis presented with complaints of fragmented sleep. MRI of the brain, cervical spine, and thoracic spine showed numerous demyelinating lesions in the brain, brainstem, cervical, and thoracic spinal cord. Upon presentation, the patient noted snoring, witnessed apneas, and daytime sleepiness. WatchPAT demonstrated severe sleep apnea, with a pAHI of 63.3, and a minimum oxygen saturation of 90%. The majority of the scored events were non-obstructive in nature (73.1% of all scored events), and occurred intermittently in a periodic fashion. Conclusion The differential diagnosis of fatigue in PwMS should include sleep-disordered breathing, including both obstructive and central forms of sleep apnea. Demyelinating lesions in the brainstem (which may contribute to impairment of motor and sensory networks that control airway patency and respiratory drive), and progressive forms of MS, have been linked to both OSA and CSA. The present data illustrate this relationship in a person with progressive MS, and offer support for the WatchPAT as a cost-effective means to evaluate for both OSA and CSA in PwMS, while reducing patient burden. PwMS may be at increased risk for CSA. Careful clinical consideration should be given to ordering appropriate sleep testing to differentiate central from obstructive sleep apnea in PwMS, particularly for patients with demyelinating lesions in the brainstem. Support (if any) 1. Braley TJ, Segal BM, Chervin RD. Obstructive sleep apnea and fatigue in patients with multiple sclerosis. J Clin Sleep Med. 2014 Feb 15;10(2):155–62. doi: 10.5664/jcsm.3442. PMID: 24532998; PMCID: PMC3899317.

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Increased Risk of Parkinsonʼs Disease in Patients With Obstructive Sleep Apnea

Medicine ◽

10.1097/md.0000000000002293 ◽

2016 ◽

Vol 95 (2) ◽

pp. e2293 ◽

Cited By ~ 31

Author(s):

Nai-Cheng Yeh ◽

Kai-Jen Tien ◽

Chun-Ming Yang ◽

Jhi-Joung Wang ◽

Shih-Feng Weng

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep ◽

Increased Risk

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Compared to Individuals with Mild to Moderate Obstructive Sleep Apnea (OSA), Individuals with Severe OSA Had Higher BMI and Respiratory-Disturbance Scores

Life ◽

10.3390/life11050368 ◽

2021 ◽

Vol 11 (5) ◽

pp. 368

Author(s):

Leeba Rezaie ◽

Soroush Maazinezhad ◽

Donald J. Fogelberg ◽

Habibolah Khazaie ◽

Dena Sadeghi-Bahmani ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Multiple Regression ◽

Daytime Sleepiness ◽

Respiratory Disturbance Index ◽

Disturbance Index ◽

Related Data ◽

Obstructive Sleep ◽

Increased Risk ◽

Respiratory Disturbance

Objective: Individuals with obstructive sleep apnea (OSA) are at increased risk to suffer from further somatic and sleep-related complaints. To assess OSA, demographic, anthropometric, and subjective/objective sleep parameters are taken into consideration, but often separately. Here, we entered demographic, anthropometric, subjective, and objective sleep- and breathing-related dimensions in one model. Methods: We reviewed the demographic, anthropometric, subjective and objective sleep- and breathing-related data, and polysomnographic records of 251 individuals with diagnosed OSA. OSA was considered as a continuous and as categorical variable (mild, moderate, and severe OSA). A series of correlational computations, X2-tests, F-tests, and a multiple regression model were performed to investigate which demographic, anthropometric, and subjective and objective sleep dimensions were associated with and predicted dimensions of OSA. Results: Higher apnea/hypopnea index (AHI) scores were associated with higher BMI, higher daytime sleepiness, a higher respiratory disturbance index, and higher snoring. Compared to individuals with mild to moderate OSA, individuals with severe OSA had a higher BMI, a higher respiratory disturbance index (RDI) and a higher snoring index, while subjective sleep quality and daytime sleepiness did not differ. Results from the multiple regression analysis showed that an objectively shorter sleep duration, more N2 sleep, and a higher RDI predicted AHI scores. Conclusion: The pattern of results suggests that blending demographic, anthropometric, and subjective/objective sleep- and breathing-related data enabled more effective discrimination of individuals at higher risk for OSA. The results are of practical and clinical importance: demographic, anthropometric, and breathing-related issues derived from self-rating scales provide a quick and reliable identification of individuals at risk of OSA; objective assessments provide further certainty and reliability.

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Abstract P068: Obstructive Sleep Apnea is Associated with an Increase Risk of Osteoporosis

Circulation ◽

10.1161/circ.131.suppl_1.p068 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Anawin Sanguankeo ◽

Sikarin Upala

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Primary Outcome ◽

Meta Analysis ◽

Systemic Disease ◽

Obstructive Sleep ◽

Increased Risk ◽

Increase Risk ◽

Osteoporosis Risk ◽

Stimulation Of

Background: Obstructive sleep apnea (OSA) is thought to be a systemic disease and has been associated with many disorders such as metabolic, endocrine, and especially cardiovascular diseases. One of the consequences of OSA is hypoxia, which can lead to a reduction in growth of osteoblast and a stimulation of osteoclast. Our meta-analysis was conducted to determine the risk of osteoporosis in patients with OSA compared to controls. Objectives: Eligible studies assessing the effects of obstructive sleep apnea on osteoporosis risk were comprehensively searched in PubMed/MEDLINE, EMBASE, and CENTRAL from their inception to September 2014. Two authors independently assessed article quality and extracted the data. Primary outcome were number of participants, prevalence, or risk ratio of osteoporosis in OSA and controls. Results: From 40 full-text articles, 3 studies involving 113,090 participants were included in the meta-analysis that were based on the random effects model. Compared with controls, participants who were diagnosed with obstructive sleep apnea had increased risk of osteoporosis (pooled risks ratio, 1.85; 95% CI, 1.34, 2.56). Conclusion: Patients with OSA had a higher risk of developing osteoporosis. Further study is needed to evaluate the possible mechanisms between these two conditions and to find potential treatment for OSA that could prevent osteoporosis.

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